Digital image analysis and display system using radiographic attenuation data

ABSTRACT

The invention provides systems, apparatus and methods for digital image processing system providing enhanced display of elements of images generated from x-ray and other forms of attenuation data converted to grayscale digital format. Such systems, apparatus and methods capture attenuation values used to render digital images and uses the data to identify distinct gradations of the grayscale, incorporating grayscale data, e.g., within and beyond the spectrum of human vision, then recursively delineates borders based on ranges of gradation, forming irregular multi-layer visual objects with delineated internal contouring and an outer boundary, and then enhancing each delineated layer and superimposes the enhancing display over the corresponding area of the original image, thereby revealing underlying morphology of masses previously obscured, hidden or “masked” from human vision. The invention operates on all digital images produced by attenuation values (i.e. x-rays and sound waves); currently the invention is deployed to display organic masses in medical x-ray images, such as mammograms, to assist in diagnostic interpretation.

This application claims the benefit of priority of U.S. Provisional Patent Application Ser. No. 62/678,644, filed May 31, 2018, and entitled “Radiologic Image Viewer,” the teachings of which are incorporated by reference herein.

BACKGROUND OF THE INVENTION

The first x-ray image of a human body part (a hand) was taken in 1895, launching the discipline of radiology. One of the first medical diagnostic applications a few years later showed a penny lodged in the throat of a child. But using x-rays to distinguish characteristics of soft tissue proved more difficult—as the attenuation of the x-rays (the relative amount that passes through tissue depending on density) is very subtle and hard to distinguish in a resulting black & while “x-ray.” It would take years until the first mammography machine were commercially used to detect masses in breast tissue. Those mammograms used x-ray film. Digital mammography was introduced in 1972 and by the 1990s digital mammograms had become standard medical practice—despite some misgivings about the hidden details that some scientists believe were lost when transitioning from analog imaging.

Today, 40 million digital mammograms are generated each year in the US and more than 50 percent now deploy advanced 3D digital mammography called tomosynthesis. Digital mammography has proven able to detect cancer early and is the only screening modality approved by the U.S. Food & Drug Administration. However, mammography is under increasing scrutiny because of persistent shortcomings with both early detection and too many false positives that lead to additional imaging and unwarranted biopsies. Both problems result in deleterious health effects for women and increase operational and litigation costs for healthcare providers. In light of these trends, several current studies reexamine the advisability of recommended screening regimes for all women.

For the majority of patients, mammography works well, but 40 percent of women have dense breast tissue that can “mask” cancer in black-and-white mammograms. This is true because both tumors and naturally occurring dense breast tissue appear as white on black-and-white mammograms. The natural dense tissue can obscure morphological characteristics of the tumor, making it much harder for the radiologist to see the grayscale gradation typically extending from the center of a tumor, where it is densest, to the outlying edges of the tumor that are typically less dense. It also makes it difficult to see extending tentacles indicative of aggressive growth and the spikes and points called spiculation that are telltale characteristics of malignancy. Importantly, women with dense breast tissue also have a higher natural incidence of cancer, so their need for a better screening method is even greater.

Although mammography is an important application of radiological imaging, there are many other medical imaging applications that suffer from shortcomings of the prior art.

Objects of the invention are to provide improved systems, apparatus and methods of medical and, more particularly, digital, imaging.

Other objects of the invention are to provide such improved systems, apparatus and methods as are suitable for medical diagnosis and/or treatment.

Further related such objects of the invention are to provide such improved systems, apparatus and methods for medical diagnosis and/or treatment that overcoming shortcomings of the prior art with respect to the foregoing.

SUMMARY OF THE INVENTION

The invention provides systems, apparatus and methods for digital image processing providing enhanced display of elements of images generated from x-ray and other imaging modalities, e.g., characterized by attenuation data converted to grayscale digital format. The invention captures attenuation values used to render digital images and uses the data to identify distinct gradations of the grayscale, incorporating grayscale data, e.g., within and beyond the spectrum of human vision, then recursively delineates borders based on ranges of gradation, forming irregular multi-layer visual objects with delineated internal contouring and an outer boundary, and then enhancing each delineated layer and superimposes the enhancing display over the corresponding area of the original image, thereby revealing underlying morphology of masses previously obscured, hidden or “masked” from human vision. The invention operates on all digital images produced by attenuation values (i.e. x-rays and sound waves); currently the invention is deployed to display organic masses in medical x-ray images, such as mammograms, to assist in diagnostic interpretation.

BRIEF DESCRIPTION OF THE DRAWINGS

The patent or application file contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing(s) will be provided by the Office upon request and payment of the necessary fee.

A more complete understanding of the illustrated embodiment may be attained by reference to the drawings, in which:

FIG. 1 depicts a system 10 according to one practice of the invention, as well as an environment in which the invention may be practiced;

FIG. 2 is a flow chart that overviews a process according to the invention for image analysis;

FIG. 3 is a flow chart depicting the capture of attenuation values in a system according to the invention;

FIG. 4 is a flow chart depicting the identification of dominant grayscale ranges sequential groupings in a system according to the invention;

FIG. 5 is a flow chart depicting the creation and sorting of polygons and contouring of tissue density gradient in a system according to the invention;

FIG. 6 is a flow chart depicting the assembly of spatially related polygons reflecting tissue morphology in a system according to the invention:

FIG. 7 is a flow chart depicting the rating, measuring, enhancing and displaying of assembled polygons in a system according to the invention;

FIG. 8 is a flow chart depicting the creation of searchable criteria for polygons saved as morphologically relevant in a system according to the invention;

FIG. 9 depicts a radiological scan without and with a pop-up utility window for image enhancement according to the invention;

FIG. 10 depicts contiguous grouping at a single grayscale value that reveals outlined shapes called Growth Rings (GR) in a system according to the invention;

FIG. 11 depicts a conceptual Pixel Gradation Mass (PGM) and a PGM as displayed in a mammogram with converging outward growth points;

FIG. 12 is a graphical illustration of concentric rings representing the Growth Rings seen in a mass on a mammogram in a system according to the invention;

FIG. 13 depicts a mammogram without and without a pop-up utility for image enhancement according to the invention;

FIG. 14 illustrates that a number of Growth Rings identified and delineated define the contours and size of the PGM in a system according to the invention;

FIG. 15 illustrates that the density of a mass is determined by calculating the average area of increase as GRs extend outward in a system according to the invention;

FIG. 16 illustrates that whiteness of a PGM is determined by brightness of the center GRs in a system according to the invention; and

FIG. 17 illustrates the modification of pop-up utility window settings in a system according to the invention.

DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENT

FIG. 1—Architecture

FIG. 1 depicts a system 10 according to one practice of the invention, as well as an environment in which the invention may be practiced. The illustrated system 10 includes a server digital data device 12 that is coupled to one or more client digital data devices 14-18 via a network 20.

Server digital data device 12 comprises a mainframe, minicomputer, workstation, or other digital data device of the type known in the art as adapted in accord with the teachings hereof for performing the functions attributed to device 12 in the discussion that follows and elsewhere herein. Server 12 may be comprise a stand-alone device or it may be co-housed with other devices of the type shown here or otherwise.

Client digital data devices 14-18 comprises workstations, desktop computers, laptop computers, portable computing devices, smart phones or other digital devices of the type known in the art as adapted in accord with the teachings hereof for performing the functions attributed to those devices 14-18 in the discussion that follows and elsewhere herein. One or more clients 14-18 may comprise stand-alone devices or they may be co-housed with other devices of the type shown here or otherwise. By way of non-limiting example, in some embodiments one or more clients 14-18 may comprise or be co-housed in medical imaging apparatus, such as, by way of non-limiting example, CT scanners, tomosynthesis equipment, while in the same or other embodiments, other such clients may be comprise or be housed in personal digital assistants, smartphones, or otherwise.

Client devices 14-18 may be coupled to graphical displays 14A-18A, respectively, or other output devices (whether integrated with the clients 14-18, networked to them or otherwise) of the type known in the art as adapted in accord with the teachings hereof for displaying and/or otherwise presenting still and/or moving images analyzed by devices 14-18 and, where applicable, by server 12. Server 12 can be similarly coupled to such a graphical display (not shown) in instances where desirable or necessary.

Network 20 comprises local area networks, wide area networks, metropolitan networks, the Internet and/or an other network or communications media (wireless, wired or otherwise) or combination thereof of the type known in the art as adapted in accord with the teachings hereof for supporting the transfer of information (in real-time or otherwise) between the illustrated devices.

It will be appreciated that the embodiment illustrated in FIG. 1 and described above is by way of example that the invention may be practiced in embodiment other than that shown here. Thus, by way of non-limiting example, although a single server and three client devices are shown in the drawing, it will be appreciated that this is by way of example and that other embodiments may include a greater or lesser number of any of those devices. It will be further appreciated that, in some embodiments, the operations ascribed herein to the server 12 may be performed by one or more of the clients 14-18 acting individually or cooperatively and, conversely, that operations ascribed to the client devices 14-18 may be performed by the server 12.

Overview of Operation

Described below are methods of operation of client devices 14-18 for image analysis in accord with the invention. The programming of such devices 14-18 for such purpose is within the ken of those skilled in the art in view of the discussions below and elsewhere herein. As evident in the discussion that follows, those devices can run independently without assistance of a server 12.

FIG. 2 is an overview of a method of the invention for image analysis and/or enhancement on a client device. The illustrated method captures the attenuation data within a designated area provided by a digital image acquisition device. (Step 101). The illustrated method initially executes image analysis by identifying the dominant grayscale values within a designated range within an area of the image or for the entire image, such as a full-sized mammogram. (102). Using an iterative process deployed by the functions of a computer, the illustrated method scans the designated area for gradation boundaries of the dominant grayscale ranges and traces those boundaries, drawing a contiguous line. As the best embodiment, the illustrated method uses the same iterative process at each grayscale range (4, 8, 16, 32, 64, 128, 256) applied to the same digital image or designated area of the digital image; this results initially in hundreds of thousands individual drawn polygons, drawn at various bit-levels, each of which was defined by linking adjacent pixels within the dominant grayscale range; this is done with and without closure functions. (103). The illustrated method uses an iterative process deployed by the function of a computer to create an inventory of all polygons and eliminates duplicates formed at different bit-levels. Using the same iterative process the illustrated method sorts the polygons and assembles multi-polygon objects using individual polygons that share spatial relationships with each other. (104) The illustrated method measures the characteristics and size of the assembled multi-polygon object and applies enhancement to each of the constituent polygons, corresponding to the grayscale range derived from the original attenuation values assigned by the image acquisition device, thereby using enhancement to highlight the grayscale gradient that corresponds to tissue density. (105) The illustrated method displays the enhanced multi-polygon object as a digital representation of a tissue mass and provides metrics of the number of polygon layers (AQ—attenuation quotient) of the mass as well as its estimated diameter, area and volume. (106). The multi-polygon “mass” can be displayed with or without the surrounding background to enhance visual analysis and can be saved to a morphological database where other multi-polygon objects are stored, allowing for searching and comparison with other multi-polygon tissue masses.

Capturing Attenuation Values

Referring to FIG. 3, systems and methods according to the invention (hereinafter, collectively, “systems” or “methods,” unless otherwise evident from context) capture the digital grayscale values based on the attenuation data recorded by the radiographic image acquisition machine i.e. a mammography x-ray machine, both 2D and 3D. The data is presented in digital format that can currently range to a grayscale as high as 1024 shades of gray. The systems convert the grayscale values to 256, which has been deemed the best mode for processing digital mammography images; however, the systems utilize grayscales ranges as low as 4 and can is able to process to the upper end 1024 grayscale as currently defined. For the purpose of mammography, the acquisition image has been processed to conform with DICOM format requirements. The systems, however, can translate any digital image format, i.e. jpeg, gif, png, bmp and any other digitized format.

Identify Dominant Grayscale Ranges Sequential Groupings (GRSGs)

Referring to FIG. 4, systems according to the invention scan the grayscale spectrum of a designated area of the image or the entire image if designated for analysis, such as a full-scale mammogram. Using a pixel by pixel analysis the systems determine the top four most common consecutive grayscale range sequential groupings (GRSGs) that are being used in the designated area. (102:1) This iterative process can also be used to determine the top 3 common GRSGs or it can be used to identify more than 4 GRSGs. A preferred mode of use for digital mammography is to use 4 GRSGs and do the image analysis of a designated area at each grayscale range from 4 to 256. For analysis of images at larger grayscales (512 or greater) a larger number of GRSGs could be identified, reflecting greater granularity.

Create and Sort Polygons Contouring Tissue Density Gradient

Referring to FIG. 5, using an iterative process deployed by the functions of a computer, the systems according to the invention use the four GRSGs to define and trace the gradient edges of the grayscale in the designated area, forming a continuous line that outlines the shape of a polygon. This is done by using an iterative function of a computer to link adjacent pixels to the pathway of an emerging polygon by following the value range of a GRSG as it defines the outside x/y pathway. Optionally, edge detection can be used to define a polygon instead of GRSG method defined above.

The systems create polygons without using closure and save the result. The systems then applies closure to the resulting polygon's outside boundary by tracing it to correct potential x/y pathway anomalies, thereby closing gaps in pixel runs that are less than 0.09 percent smaller of either the width or height; if that results in a value of less than 20 pixels then 20 pixels is used. The process of the inventive systems referenced here represent current best mode for mammography—other cut off values could be applied when performing closure.

Methods according to the invention use an iterative process, defining a GRSG for each level of grayscale and then traces the polygons at those levels—4, 8, 16, 32, 64, 128, 256. The methods use closure as above and then saves the results, creating as many has several hundred thousand individual polygons.

Using an iterative process deployed by a computer, the methods sort the numerous polygons initially created, eliminating: 1) duplicates generated at different grayscale levels and by closure; 2) polygons that assume shapes beyond permissible parameters set by ratios that define anomalous polygon forms that could not represent targeted tissue masses i.e. breast implants, implanted devices, physical barriers such as the edge of the mammogram, or known artifacts of compression in mammograms. The methods sequentially sorts the polygons by the average of its original grayscale values and orders it by size, beginning with the smallest, when the grayscale value are the same.

Assemble Spatially Related Polygons; Reflecting Tissue Morphology

Referring to FIG. 6, systems according to the invention use an iterative process deployed by a computer, e.g., 14-18, to assemble polygons into multi-polygon objects that reflect the tissue morphology of masses contained in the designated area i.e. an area of defined by visualization window or the entire mammogram. Using an iterative function of a computer, the systems assemble (“stacks”) the polygons that are inclusive of one another, overlapping the same x/y area. The systems do the ordering based on a “child-parent” relationship that orders the layering of the polygons based on a hierarchy that corresponds with density gradients. The polygons registering the highest density fall in the center of the mass—reflecting the fact that malignant masses typically have dense cores and malignant tissue radiates out from such cores with decreasing density. The systems use an iterative process deployed by a computer to assemble these polygons from high density to low density and smallest to largest—assuring that a denser polygon must fit within the boundaries of a lower density polygon. This can result in a lower density polygon having several higher density polygons located within it—reflecting the complexity of tissue morphology.

Rating, Measuring, Enhancing and Displaying Assembled Polygons

Referring to FIG. 7, using an iterative process with a computer, e.g., 14-18, systems according to the invention records the total number of polygons that make up a completed “mass” and presents that as a rating value called “Attenuation Quotient” (AQ). In the case of a multi-variant polygon (with denser polygons inside less dense polygons), the AQ displayed is of the densest polygon stack.

The systems use a computer to measures using pixel count the largest diameter, the average diameter and shortest diameter and converts those measurements to image acquisition millimeters/centimeters as defined in the DICOM file or other standardization data. Using similar pixel count processing, the invention calculates the area of the largest polygon of the mass. In the case of 3D images, the area of the mass as seen as in the consecutive tomosynthesis slices is factored by the computer, taking into consideration the known distance between slices, in order to calculate the volume.

The systems re-shade or colorize (depending on the capacity of the display monitor in use) each polygon using grayscale ranges and/or colors that the human eye can differentiate. The multi-polygon “mass” can be displayed with or without the surrounding background to enhance visual analysis.

Creating Searchable Criteria for Polygons Saved as Morphologically Relevant

Referring to FIG. 8, the criteria for searching both 2d and 3d masses is based on the comparison of all the constituent polygons of a targeted mass. This comparison is done in through a set of percentages to allow for similar morphological masses to be compare even when their relative size is different. To make these percentage-based criteria, the invention uses a computer to define the tightest square possible around each mass (assembled polygon(s)) and uses that square area to calculate the relative comparative percentage. The following comparative percentage are calculated based

-   1) A ratio of height versus width for each mass expressed in a range     from 1 to 200 percent. -   2) The percentage of pixels used by the polygon in the total square -   3) The average location of the x and y pixels within the each     square—defining the relative positioning -   4) The average vertical and horizontal pixel run length, where a run     length is defined as a contiguous and aligned set of pixels running     either horizontal or vertical but not diagonal.

Using a computer to execute the above calculations allows for searching for and comparisons among other multi-polygon tissue masses held in a database despite differences in relative size and the variance of minor morphological characteristics.

Advantages

Prior art 3D mammography imaging machines capture extremely slight differences in attenuation—distinctions when converted to grayscale imaging that are beyond the range of human vision. Systems according invention overcomes this problem by capturing the attenuation values to be assigned each pixel, thereby calculating various gradients in the visible and invisible range, then using those gradients to trace the polygons that reflect contours of the mass. Such systems then re-assemble the spatially-related polygons into a morphological whole and colorize each gradation layer to distinguish the constituent gradations thereby revealing the morphological details once hidden. In addition, because systems according to the invention can isolate the contours of the tumor at the attenuation value level, other innovative computations are possible. For example, the systems can use the attenuation value data to calculate the size and shape of the tumor in each of the 2D slices that tomosynthesis imaging uses to render a composite “3D image” As a result, systems according to the invention can calculate the volume of a mass in a mammogram—a key metric when considering treatment options for breast cancer.

Prior art provides computer-aided imaging solutions have been applied to mammography, known as Computer Assisted Diagnosis. Such systems commonly used rules-based pattern recognition to identify areas on a mammogram that could contain a malignant mass. CAD systems mark areas of suspicion on the mammogram with an X or some other graphical designation. However, a 2015 mega-study concluded that CAD did not improve breast cancer detection and today CAD is no longer eligible for reimbursement and has largely been abandoned by radiologists. Renewed hope for computer-aided detection in mammography has come with the emergence of various machine learning applications. Like CAD these systems are attempting to identify areas of suspicion. In addition, these new Machine Learning/AI systems purport not only to mark an area of suspicion but produce scores rating the probability of malignancy. Machine Learning/AI applications produce results derived through pattern analysis and recognition within the black & white digital image; the systems “train” the software on known malignant masses and then use evolving algorithms to match similar black and white patterns that appear in the target mammogram; the more similar the pattern, the higher the malignancy score. As the software trains on more and more images, it is expected to improve its pattern recognition and related scoring.

Systems according to the invention are distinct from prior art pattern-recognition systems. Those according to the invention do not train on a set of curated mammograms with known malignant masses and does not mark an area as suspicious and offer a predictive quantification based on pattern recognition. As described herein, systems according to the invention reveal underlying morphology through the processing of attenuation values captured by the digital image acquisition device and recorded in a digital image such as a mammogram. Further, systems according to the invention displays the results through visualization by utilizing colorization defined by pixel gradation contouring calculated uniquely on each targeted image. The metrics—number of layers, diameter, area and volume of the revealed mass—are directly computed from the contouring of density gradation embodied in the target image and not the result of pattern recognition or the use of the trained datasets of machine learning.

Example

Described below are operations of the client devices 14-18 and server 12 in an exemplary system according to the invention that provides for pop-up display of the results of image analysis according to the invention. The programming of such devices 12-18 for such purpose is within the ken of those skilled in the art in view of the discussions below and elsewhere herein.

-   -   1. This example describes a utility that is used in systems         according to the invention to view radiologic images in a poop         window—referred to below as the “DeepLook window.” The pop-up         utility works directly on the display of medical monitors and/or         other digital displays used to view, evaluate and/or compare         radiologic images. It performs a screen grab of the current         monitor Pixel Gradation Mass (PGM) pixel settings and analyzes         them. The image in FIG. 9 shows a mammogram with and without the         DeepLook window.     -   2. The technology supporting the pop-up window analyzes pixel         gradation directly from the digital screen. It analyzes the         image displayed regardless of the modality used to acquire the         image. The software works on any medical image presented in         grayscale or color, including but not limited to mammography and         ultrasound.     -   3. The software groups pixels deemed similar in brightness on a         continuum of the grayscale (color pixels are converted to a         corresponding grayscale). DeepLook converts them into a single         grayscale value—thereby creating areas of contiguousness. As         shown in FIG. 10 contiguous grouping at a single grayscale value         reveals outlined shapes called Growth Rings (GR).     -   4. The grouping method that creates Growth Rings (GR)         establishes ordering according to relative brightness. In         radiology (x-rays), MRI, MBI and other technologies, the         ordering is done in descending steps from white to black; in         ultrasound the ordering occurs in ascending steps from black to         white. This ordering method creates overlapping GRs; they are         recursive and display as shapes within shapes, according to each         GR's grouped grayscale value.     -   5. This grouping, ordering (descending or ascending) and         recursive overlapping effectively displays outward growth from         one or more points to a final outward shape called a Pixel         Gradation Mass (PGM). Note: a mass may have several growth         points that converge as they grow outward.     -   6. In FIG. 11, the image on the left is a conceptual Pixel         Gradation Mass (PGM). On the right of FIG. 11 is a PGM as         displayed in a mammogram with converging outward growth points.     -   7. The technology supporting the pop-up window initially         differentiates grayscale at the single pixel level—gradation         beyond the range of normal human vision. It then highlights with         color the constituent Growth Rings (GRs) created by pixel shade         grouping described above in items #3 and #4. These GRs are         invisible or not readily visible to the human eye. The software         applies colorization to highlight and distinguish GRs within the         Pixel Gradation Mass (PGM).     -   8. FIG. 12 is a graphical illustration of concentric rings         representing the Growth Rings seen in a mass on a mammogram. On         the left of FIG. 12, the box contains concentric rings         representing the growth rings of an organic mass. The space may         appear nearly blank but is not. The concentric rings are there         but the grayscale distinction between each ring is effectively         impossible to see. On the right side of the box in FIG. 4 is         exactly the same image enhanced by the software technology; it         delineates the rings by highlighting with scaled color.     -   9. Unlike the graphical illustration above, growth rings derived         from radiological images of organic tissue are irregular in         shape and not cleanly delineated. Below, the technology is         applied directly to a 2D mammogram. In FIG. 13, the image on the         left is a bright white area on the mammogram; this is typically         indicative of a possible mass but the features are hard to         discern because of the uniform whiteness. On the right of FIG.         13 is the identical bright white area as viewed with the pop-up         utility. Organic concentric pixel shading is visible, as the         technology of the pop-up utility displays a Pixel Gradation Mass         (PGM) with over 12 Growth Rings (GRs).     -   10. The technology and methods behind the pop-up utility uses a         set of ratios, weighted averaging techniques and other         calculations to establish the dimensions of a Pixel Gradation         Mass (PGM). The PGM's contour and size result from the total         number of Growth Rings (GRs) created by pixel gradation analysis         (items #3-6 above); and the gradation occurs in ascending or         descending ordering depending on the mode of image acquisition         (radiology, ultrasound, etc.). The number of Growth Rings         identified and delineated define the contours and size of the         PGM. See FIG. 14.     -   11. The technology and methods behind the pop-up utility provide         an overall density value expressed on a scale of 0-10 to inform         the user and assist in comparisons and analysis. The density         rating of the Pixel Gradation Mass (PGM) is determined by         calculating the average area of increase as the Growth Rings         radiate out from the center.         -   Density defined: Density of a mass is determined by             calculating the average area of increase as GRs extend             outward. The density rating is normalized from 0 to 10             against all other mapped masses. The illustration in FIG. 15             has density of 7.5.     -   12. The technology and methods behind the pop-up utility provide         an overall measure of “whiteness” (or “darkness” for ultrasound         and similar modalities) which corresponds to density in         radiological images. The value of whiteness (or darkness) is         expressed on a scale of 0-10 to inform the user and assist in         comparisons and analysis. Whiteness of a Pixel Gradation Mass         (PGM) is determined by the density rating of core layers within         a PGM.         -   Whiteness defined: Whiteness of a PGM is determined by             brightness of the center Growth Ring(s) (GR). Whiteness is             normalized from 0 to 10 against all other mapped masses             within the area defined by outlines of the pop-up utility.             It is possible to expand or contract the size of the window,             resulting in a new comparative calculation. The illustration             in FIG. 16 has a whiteness of 10.0 on a grayscale of 0-256.     -   13. The default setting of the pop-up utility displays the Pixel         Gradation Mass (PGM) having the most Growth Rings (GRs) within         the range of the perimeter of the pop-up window. The default         settings can be modified by the user to expand or reduce the         number of masses highlighted in the window and the minimum         number of GRs a mass must have to be displayed by drop-down         menus in the setting window. Additionally, the window display         can be filtered manually by adjusting any of four inter-related         variables below. The variables are actuated by clicking the         settings icon on the pop-up utility menu bar found along the top         of the window. As illustrated in FIG. 17, the following are the         four variables:         -   R=the number of Growth Rings (GRs).         -   L=the size of the outermost GR in relation to the other             Pixel Gradation Masses (PGM) being analyzed in the same             popup window. 1=smallest, N=largest—1 to N.         -   W=the PGM's highest grayscale-grouped GR value (for x-rays),             or lowest grayscale value (for ultrasound).         -   D=the PGM density as described in item #11 above.     -   14. The technology and methods behind the pop-up utility create         a unique set of numerical values associated with each Pixel         Gradation Mass (PGM) that taken together create an electronic         “profile” of the mass. The electronic profile—called a Mass         Tissue Profile (MTP)—can be used to execute specialized         visual-based searches in a custom MTP database, revealing         matches and correlations of other MTPs derived from additional         medical images.

Pseudo-Code

Following is the pseudo-code for creating the Pixel Gradation Mass (PGM) and other capabilities outlined above:

-   -   1. Move the pop-up window over the screen area to be analyzed.         Alternatively, analysis can be of a specific area of an image         from a data file such as *.jpg, *.gif, DICOM, *.PNG, *.TIFF,         etc.     -   2. Do a “screen grab” of the current monitor's pixels.         Alternatively, an image file of any type such as *.jpg, *.gif,         DICOM, *.PNG, *.TIFF, etc. converted to a pixel display similar         to a “screen grab” can be used.     -   3. Locate the area directly under the pop-up window display—or         alternatively, select the area from an image file converted to a         pixel display. Copy those pixels in the selected file to a         standalone file; alternatively, work from the grabbed pixel         memory using selected area offsets, or similar methods for         reading and managing the pixel information.     -   4. Search the selected area for contiguous pixel groups—making a         list sorted by brightness. Below are the steps used in the         DeepLook pop-up window to create contiguous pixel groups. A         contiguous pixel group is a group of pixels having the same         shade, or similar shading, that are touching (“contiguous”).         Alternatively, any other method that generates contiguous pixel         groups can be used.         -   DeepLook pseudo-code used to “generate continuous pixel”             groups:         -   A. Create an array of integers having one grayscale value             for each pixel for all the pixels “screen grabbed”. The             maximum grayscale value is variable. In the DeepLook             implementation, the maximum grayscale value is 255. Starting             with the top-upper-right pixel, working left-to-right and             top-down in the selected area, value create a single integer             value for each pixel representing its assigned grayscale             value. If Red=Green=Blue, the value would be the current Red             value. If Red, Green or Blue are not all the same, then use             a color-to-grayscale pixel formula to convert the pixel             value to grayscale. This implementation uses             “luma=red*0.3+green*0.59+blue*0.11.” Alternatively, any             formula or algorithm can be used to create a single value             from the three RGB values of the pixel, if not a grayscale             pixel representation.         -   B. Use the grayscale array as an X to Grab Width, and Y to             Grab Height—as a rectangular representation of the grabbed             area. Starting with the maximum number of possible shades of             gray for the screen area, scan the array for contiguous             pixel groupings. For each scan of the array, reduce the             grayscale value of each array value by the power of 2 (bit             shift right 1) until the maximum value is 3—which is a total             of 4 possible shades of gray.             -   If the maximum grayscale value is 255 on the first scan                 through the array, the maximum value that any array                 element can have is 255. On the second runthrough of the                 array, the maximum value would be 127; on the third, the                 value would be 63.             -   For each array scan, when a contiguous pixel group is                 found, then the parameters that define the group must be                 saved. The below parameters are kept in this                 implementation that are used later in this                 implementation. Alternatively, any additional parameters                 can be saved which may, or may not, be used at a later                 date. And of the below parameters based on the current                 implementation can be skipped.             -   1. X and Y pixel point path containing and outlining the                 continuous pixel group.             -   2. All continuous pixel groups are identified by the                 actual pixel rectangle surrounding the shape. The                 percentage of the pixel area that the shape covers in                 its pixel rectangle.             -   3. The average pixel X position of each pixel used in                 the shape in relation to its actual pixel rectangle.             -   4. The average pixel Y position of each pixel used in                 the shape in relation to its actual pixel rectangle.             -   5. The average run length of the continuous                 right-to-left pixel length that make up the shape.             -   6. The average run length of the continuous                 top-to-bottom pixel length that make of the shape.             -   7. The shape's width             -   8. The shape's height             -   9. The total XY point count of the XY point path (1                 above)             -   10. The average grayscale pixel value of the shape.             -   11. The XY position of every pixel in every shape saved.         -   C. Run through list of saved shapes and remove duplicate             shapes.     -   5. Using the shape data saved from 4(B) above, create a matrix         table of shapes found. The table identifies where shapes         intersect and/or overlap—and is used when creating concentric         pixel gradation.     -   6. Search for concentric pixel gradation masses, creating a list         of them. Searching for concentric pixel gradation is broken down         into the following steps (alternatively, other alternative         methods to search for concentric pixel gradation can be used):         -   A. Sort shape list with the brightest first, then largest.         -   B. Starting at the top of the list, for each shape on the             list that has not been assigned to a mass already, perform             step B.1 below:         -   B.1 Using the matrix table of shapes created in step 5             above, search the shape pixel rows and columns looking for             shapes that completely surround it. If a shape is found that             completely surrounds the current shape, and if any of the             following are true, grab the next shape on the list:             -   1. Its average grayscale is greater then the current                 shape's average grayscale.             -   2. The absolute value of the found shape's grayscale                 minus the current grayscale shape is greater then N. In                 the implementation, N=6. Alternatively, any N value can                 be used.             -   3. The total area of the found shape is greater then N.                 In this implementation, N varies depending on the shape                 size. Smaller shapes have different settings then larger                 ones. See the attached code for specific definitions.                 Alternatively, this code can be implemented using other                 size constraints.             -   4. Shape width and height ratio do not match within a                 specific range of N. N varies in this implementation                 depending on the shape size. Smaller sizes have                 different settings then larger ones. See the attached                 code for specific defines. Alternatively, this code can                 be implemented using other size constraints.         -   C. If here, then the found shape is now considered a ring of             the current shape. If the current shape is from the “B” list             above, the current shape is saved as a mass. The found shape             now becomes the current shape—and then proceed to B.1. The             current concentric pixel gradation mass is considered             complete once there are no other shapes surrounding the             current shape that are not excluded by B.1.     -   7. If here, now have a list of all concentric pixel gradation         masses found. Search for pixel gradation masses matching the         current filter settings.         -   A. Scan the concentric pixel gradation masses list for             masses that meet the current filter specification.         -   B. Using the X Y Path defined 4.B above, draw each massed             found, using a different color range for each shape found in             the masses. Optionally, display saved parameters in 4.B             above and or the averaging of the shapes found in the mass.             Alternatively, only selected shapes from the identified             masses can be displayed.

A more complete understanding of the operations effected by the pseudo-code above may be attained by reference to incorporated-by-reference provisional patent application 62/678,644 and, specificially, the source code provided therein under the heading “DeepLook Source Code,” which source code is explicitly incorporated by reference herein.

Described above systems, apparatus and methods meeting the objects set forth previously. It will be appreciated that the illustrated embodiments are merely examples of the invention and that other embodiments incorporating changes to those shown here fall within the scope of the invention, of which we claim: 

The invention claimed is:
 1. An image processing method of image enhancement, comprising: capturing attenuation values used to render a digital image; identifying from the captured values distinct gradations of the grayscale; recursively delineating borders based on ranges of gradation; forming irregular multi-layer visual objects with delineated internal contouring and an outer boundary, and enhancing each delineated layer and superimposing the enhancing display over the corresponding area of the original image.
 2. An image processing system and apparatus operating in accord with the method of claim
 1. 3. An image processing systems and apparatus according to claim 2 that generates an enhanced image of the type shown in FIG. 9, 11, 13 or
 17. 